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COMMUNITY TAX CERTIFICATE

YEAR PLACE OF ISSUE (City/Mun./ Prov)

INDIVIDUAL
DATE ISSUED

CC12012

11793510

2013
NAME (SURNAME)

CITY OF BAGUIO
(FIRST)

06-10-13
(MIDDLE) TIN (If Any)

TAXPAYERS COPY

GASATAN,
ADDRESS

JOAN
ICR NO. (If an Alien) PLACE OF BIRTH

M
SEX: 1 2 MALE FEMALE HEIGHT

P9 115 GABRIELA SILANG BC


CITIZENSHIP

Filipino
CIVIL STATUS Separated 1 1 1

Benguet
DATE OF BITRH Widow/Widower/Legally

5
WEIGHT

02/27/92
TAXABLE AMOUNT

50
COMMUNITY TAX DUE

1 PROFESSION / OCCUPATION / BUSINESS

Single
A. BASIC COMMUNITY TAX (5.00) Voluntary or Exempted (1.00) B. ADDITIONAL COMMUNITY TAX (tax not to exceed P5,000.00)
1. 2. 3. GROSS RECEIPTS OR EARNINGS DERIVED FROM BUSINESS DURING THE PRECEDING YEAR (P1.00 for every P1,000.00) SALARIES OR GROSS RECEIPT OR EARNINGS DERIVED FROM EXERCISE OF PROFESSION OR PURSUIT OF ANY OCCUPATION (P1.00 for every P1,000.00) INCOME FROM REAL PROPERTY (1.00 for every 1,000.00)

5.00 P

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TAXPAYERS SIGNATURE

TOTAL INTEREST TOTAL AMOUNT PAID


(In words):

P 5.00 P 0.60 5.60

ALICIA L. ONOZA ICO, City Treasurer MUNICIPAL/CITY TREASURER DOP: 04.20.2012

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